EDWARD CARL BERGEN D.O.
NPI 1760454391
Internal Medicine - Interventional Cardiology in Lake Charles, LA

NPI Status: Active since February 07, 2006

Contact Information

1717 OAK PARK BLVD FL 2
LAKE CHARLES, LA
ZIP 70601
Phone: (337) 494-3278
Fax: (337) 494-3240

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Secondary Locations
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 25
Internal Medicine
Interventional Cardiology
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About EDWARD BERGEN

This page provides the complete NPI Profile along with additional information for Edward Bergen, an internist established in Lake Charles, Louisiana with a medical specialization in Internal Medicine, focusing in interventional cardiology and more than 25 years of experience. He graduated from Rowan University School Of Osteopathic Medicine in 2002. The healthcare provider is registered in the NPI registry with number 1760454391 assigned on February 2006. The practitioner's primary taxonomy code is 207RI0011X with license number DO000438 (LA). The provider is registered as an individual and his NPI record was last updated 4 years ago.

NPI: 1760454391
Provider Name: EDWARD CARL BERGEN D.O.
Gender: Male
Entity Type: Individual
Location Address: 1717 OAK PARK BLVD FL 2 LAKE CHARLES, LA 70601
Location Phone: (337) 494-3278
Location Fax: (337) 494-3240
Mailing Address: PO BOX 122152 DEPT 2152 DALLAS, TX 75312
Mailing Phone: (337) 494-2772
Mailing Fax: (337) 494-3240
Medical School Name: ROWAN UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE
Graduation Year: 2002
Is Sole Proprietor?: No
Enumeration Date: 02-07-2006
Last Update Date: 03-25-2022
Code Navigator

An internist like Edward Bergen is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

109 W 4th St
Deridder, LA 70634
(337) 494-3278
1322 Elton Rd Ste P
Jennings, LA 70546
(337) 494-3278
122 W 4th St
Dequincy, LA 70633
(337) 494-3278
913 E Kent Dr
Sulphur, LA 70663
(337) 527-3610

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Internal Medicine Interventional Cardiology
Taxonomy Code: 207RI0011X
Type: Allopathic & Osteopathic Physicians
License No.: DO000438
License State: LA
Taxonomy Description: An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Ambetter from Arkansas Health & Wellness

Choice Bronze HSA (QualChoice) - POS
Complete Gold - PPO
Complete Gold + Vision + Adult Dental - PPO
Connected Silver - PPO
Connected Silver (QualChoice) - POS
Connected Silver (QualChoice) + Vision + Adult Dental - POS
Connected Silver (QualChoiceLife) - PPO
Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
Connected Silver + Vision + Adult Dental - PPO
Elite Bronze - PPO

Ambetter from Louisiana Healthcare Connections

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Elite Bronze - EPO
Elite Bronze + Vision + Adult Dental - EPO
Elite Gold - EPO
Elite Gold + Vision + Adult Dental - EPO
Everyday Bronze - EPO
Everyday Bronze + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO

Ambetter from Magnolia Health

Choice Bronze HSA - HMO
Choice Bronze HSA + Vision + Adult Dental - HMO
Complete Gold - HMO
Complete Gold + Vision + Adult Dental - HMO
Everyday Bronze - HMO
Everyday Bronze + Vision + Adult Dental - HMO
Everyday Gold - HMO
Everyday Gold + Vision + Adult Dental - HMO
Standard Expanded Bronze - HMO
Standard Expanded Bronze + Vision + Adult Dental - HMO

Ambetter from Superior HealthPlan

Complete Gold - EPO
Complete Gold + Vision + Adult Dental - EPO
Enhanced Diabetes Care Silver with $0 Drug Options - EPO
Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
Everyday Gold - EPO
Everyday Gold + Vision + Adult Dental - EPO
Focused Silver - EPO
Focused Silver + Vision + Adult Dental - EPO
Standard Gold - EPO
Standard Gold + Vision + Adult Dental - EPO

Blue Cross and Blue Shield of Louisiana

Blue Max 70/50 $6700 with 2 $0 PCP Virtual Visits HSA Eligible - PPO
Blue Max 80/60 $1500 with 2 $0 PCP Virtual Visits - PPO
Blue Max Copay (PCP) 50/50 $3300 with 2 $0 PCP Virtual Visits - PPO
Blue Max Copay (PCP) 50/50 $7500 Standardized HSA Eligible - PPO
Blue Max Copay (PCP) 60/40 $6000 Standardized - PPO
Blue Max Copay (PCP) 75/55 $2000 Standardized - PPO
Blue Saver 60/40 $6100 - PPO
Blue Saver 90/70 $3400 - PPO

HMO Louisiana

Blue POS 60/40 $6500 with 2 $0 PCP Virtual Visits HSA Eligible - POS
Blue POS 80/60 $3200 with 2 $0 PCP Virtual Visits - POS
Blue POS 90/70 $9900 with 2 $0 PCP Virtual Visits HSA Eligible - POS
Blue POS Copay (PCP) 50/50 $7500 Standardized HSA Eligible - POS
Blue POS Copay (PCP) 60/40 $6000 Standardized - POS
Blue POS Copay (PCP) 75/55 $2000 Standardized - POS
Blue POS Copay (PCP) 80/60 $1000 with 2 $0 PCP Virtual Visits - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Edward Bergen is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Edward Bergen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME) and a Home Health Agency (HHA).

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 6002064581
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20160815000962
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: No

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Coronary angioplasty and stenting
Electrocardiogram (ecg) 2-day continuous with review and report by health care professional
Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
Established patient office or other outpatient visit, 30-39 minutes
Evaluation of implantable heart and blood vessel monitoring system
Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days
Evaluation of single, dual, multiple lead or leadless pacemaker system
Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days
Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days
Evaluation of single, dual, or multiple lead implantable defibrillator system
Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days
Exercise or drug-induced heart stress test with electrocardiogram (ecg)
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
Follow-up hospital inpatient care per day, typically 35 minutes
Heart rhythm recording continous external ekg over more than 48 hours up to 7 days
Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days
Initial hospital inpatient care per day, typically 30 minutes
Initial hospital inpatient care per day, typically 50 minutes
Initial hospital inpatient care per day, typically 70 minutes
Injection, regadenoson, 0.1 mg
Insertion of pacemaker and upper and lower heart chamber electrode
Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch
Insertion of tube in coronary artery for diagnosis with review by radiologist
Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist
Leg revascularization (restoring blood flow)
New patient office or other outpatient visit, 30-44 minutes
Nuclear medicine studies of heart muscle at rest and with stress and spect
Nuclear medicine studies of heart muscle at rest and with stress and spect
Pacemaker insertion or repair
Programming of dual lead pacemaker system
Replacement of aortic valve through the skin and femoral artery
Review by radiologist of arm or leg artery image
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
Tc-99m from non-highly enriched uranium source, full cost recovery add-on, per study dose
Technetium tc-99m sestamibi, diagnostic, per study dose
Ultrasound of both sides of head and neck blood flow
Ultrasound of both sides of head and neck blood flow
Ultrasound of heart during rest, exercise and/or drug-induced stress with report
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function
Ultrasound of heart with probe in esophagus, with report
Ultrasound of heart, follow-up
Ultrasound of leg arteries or artery grafts
Ultrasound study of arm and leg arteries

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $31.15 for a new patient copayment and $23.77 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 70601 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $124.6
Minimum New Patient Price $53.43
Maximum New Patient Price $164.73

Average New Patient Copayment $31.15
Minimum New Patient Copayment $13.35
Maximum New Patient Copayment $41.18

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

Average Established Patient Price $95.09
Minimum Established Patient Price $16.64
Maximum Established Patient Price $133.62

Average Established Patient Copayment $23.77
Minimum Established Patient Copayment $4.16
Maximum Established Patient Copayment $33.4

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
e-Prescribing	100%	1038
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange	67%	88
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Medication Reconciliation	82%	415
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	88%	1037
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Provide Patient Access	51%	1037
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	48%	1037
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Edward Bergen is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
WEST CALCASIEU CAMERON HOSPITAL	701 EAST CYPRESS STREET SULPHUR, LA 70663	(337) 527-7034	Acute Care Hospitals
LAKE CHARLES MEMORIAL HOSPITAL	1701 OAK PARK BLVD LAKE CHARLES, LA 70601	(337) 494-3000	Acute Care Hospitals

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1760454391, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 12 → 1 + 2

Pos 4

Unchanged

Pos 5

Doubled → 8

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 18 → 1 + 8

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 4 → 8 4 → 8 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 2 + 0 + 8 + 5 + 8 + 3 + 1 + 8 + 24 = 69

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1

This NPI is valid

The calculated check digit is 1, which matches the last digit of 1760454391.